A Preliminary In Vivo Assessment of Anterior Cruciate Ligament-Deficient Knee Kinematics With the KneeM Device: A New Method to Assess Rotatory Laxity Using Open MRI.

Background: Methods of objectively measuring rotational knee laxity are either experimental or difficult to use in daily practice. A new method has been developed to quantitatively assess rotatory laxity using an open MRI system and new tool, the KneeM device.

Purpose/hypothesis: To perform a preliminary evaluation of a novel knee rotation measurement device to assess knee kinematics during flexion in an MRI field, in both anterior cruciate ligament (ACL)-deficient and healthy contralateral knees.

Is intra-aortic balloon pump absolutely contraindicated in type A aortic dissection?

Aim: Circulatory failure following surgery for type A aortic dissection is frequent and associated with a high mortality rate. The intra-aortic balloon pump (IABP) is used to treat postcardiotomy cardiogenic shock but aortic dissection is traditionally a contraindication. In 10 patients we used IABP for severe cardiogenic shock following aortic dissection surgery, here we report on the short and midterm results.

Emergency extracorporeal membrane oxygenation in a hospital without on-site cardiac surgical facilities.

Aims: We report the feasibility and outcomes of emergency extracorporeal membrane oxygenation (ECMO) implantation by a cardiac catheterisation team in patients in severe cardiogenic shock or refractory cardiac arrest in a hospital without cardiac surgical facilities.

Methods And Results: This prospective cohort study involved 51 consecutive patients who had ECMO implantation (September 2006 - September 2010). Twenty-seven were in severe cardiogenic shock and 24 in refractory cardiac arrest (17 with out-of-hospital cardiac arrest; seven with in-hospital cardiac arrest).

Haemostasis of a right ventricle-gunshot wound using a novel haemostatic vacuum device.

Heart wounds are frequently fatal. The haemorrhage from a right ventricle-gunshot wound in a male patient was successfully controlled using a novel haemostatic vacuum device. This case report shows how this simple, quick and efficient method can be used to control critical bleedings.

Extraction of substernal goitre using an innovative vacuum device.

The extraction by cervicotomy of substernal goitres may be impossible and sometimes requires the enlargement of the thoracic inlet with at least a sternal-split. We present the extraction of a posterior mediastinal substernal goitre with the application of an innovative vacuum-based suction device, previously used for the control of bleeding from the heart and great vessels in clinical and experimental conditions.

Percutaneous drainage of postoperative pericardial effusion in cardiac surgery.

Background And Aim Of The Study:  Postoperative pericardial effusion is frequent and can be complicated by cardiac tamponade. Although the different drainage techniques are well described in the setting of medical effusion, there is not a standard postoperative effusion treatment. The aim of this work was to assess the feasibility and effectiveness of the percutaneous pericardial drainage.

Direct admission to the operating room: an efficient strategy for patients with diagnosed or highly suspected acute type a aortic dissection.

Background: Acute type A aortic dissection (ATAAD) is a life-threatening condition with a poor acute prognosis, which requires rapid and effective surgical management. The aim of this study is to assess our strategy with regard to this condition.

Methods: According to a regional emergency protocol, patients with diagnosed or highly suspected ATAAD are directly transferred to the cardiac operating room.

[Hip and pelvic injuries in the elderly].

Fractures of the hip and pelvis are frequent and serious injuries in elderly patients. Due to the aging population, their incidence should double by 2050. Therefore, the social and economical implications of these fractures are significant.

Benefits of home-based endurance training in lung transplant recipients.

Background: To investigate the effect of home-based exercise training on exercise tolerance, muscle function and quality of life in lung transplant recipients (LTR).

Methods: Twelve LTR and 7 age-matched healthy subjects underwent exercise training (ET, 12-wk, 3×/wk, 40 min). Peak aerobic capacity VO2peak, endurance time (T(end)), minute ventilation (VE) quadriceps strength, percentage of type I fiber (%Ifb), fiber diameters and chronic respiratory questionnaire were assessed before and after ET.

An aortic ring: from physiologic reconstruction of the root to a standardized approach for aortic valve repair.

Objective: We suggest standardizing aortic valve repair using a physiologic approach by associating root remodeling with resuspension of the cusp effective height and external subvalvular aortic ring annuloplasty.

Methods: A total of 187 patients underwent remodeling associated with subvalvular aortic ring annuloplasty (14 centers, 24 surgeons). Three strategies for cusp repair were evaluated: group 1, gross visual estimation (74 patients); group 2, alignment of cusp free edges (62 patients); and group 3, 2-step approach, alignment of the cusp free edges and effective height resuspension (51 patients).

An innovative technique to control bleeding with vacuum device.

Bleeding is one of the major problems during surgery as well as in cases of accidental vascular injury. Control of bleeding can be life threatening in two surgical circumstances: when the wound is difficult to expose, and when the tissue too fragile to suture. Following more than 100 animal tests, we developed an innovative vacuum-based suction device, which enables us to address this challenge.

Aminoterminal propeptide of type III procollagen (PIIINP) is associated with ascending aortic aneurysm growth rate.

Unlabelled: Plasma levels of PIIINP a marker of extracellular matrix metabolism activity have been linked to abdominal aortic aneurysm growth rate, but its relationship with thoracic aortic aneurysm (TAA) growth has never previously been studied.

Objective: To demonstrate the value of assay of "aminoterminal propeptide of type III procollagen" (PIIINP) to predict the growth of ascending TAA.

Methods And Results: Thirty consecutive patients with asymptomatic ascending TAA were recruited and PIIINP was measured.

An aortic ring to standardise aortic valve repair: preliminary results of a prospective multicentric cohort of 144 patients.

Objectives: Multiplicity of aortic valve repair or sparing techniques results in a lack of standardisation, limiting widespread adoption of such procedures. To treat dilated diameters at the aortic annular base and sinotubular junction while maintaining root dynamics, we propose a standardised and physiological repair approach to the surgical management of aortic root aneurysms, consisting of root remodelling, cusp re-suspension and subvalvular aortic ring annuloplasty.

Methods: From May 2003 to September 2009, 144 unselected patients with aortic root aneurysms underwent remodelling with external subvalvular ring annuloplasty in 13 centres (21 surgeons).

[The association of VAC® therapy, titanium plates osteosynthesis and bilateral pectoral muscle flaps in the management of postoperative mediastinitis in an obese and diabetic patient].

Postoperative mediastinitis is one of the most worrisome complications after heart surgery. Until now there is no universally accepted strategy in the management of this infectious complication. Recently, various novel techniques like negative pressure therapy and titanium plates sternal reconstruction have allowed a dramatic decrease of mortality and morbidity after mediastinitis.

[Percutaneous extracorporeal life support in acute severe hemodynamic collapses: single centre experience in 100 consecutive patients].

Background: Extracorporeal life support (ECLS) is a circulatory assistance device that is increasingly used in adults undergoing cardiopulmonary arrest (CPA) or hemodynamic collapse when conventional therapies fail.

Objectives: To assess the feasibility and outcomes of 100 consecutive arteriovenous percutaneous ECLS procedures at the Grenoble University Hospital between January 2002 and September 2007.

Methods: Monocentric descriptive registry with one-year prospective follow-up.

Endovascular stent-graft management of aortic intramural hematomas.

Purpose: To report initial experience with endovascular stent-grafting in aortic intramural hematoma (IMH).

Materials And Methods: From 2000 to 2006, 15 patients (mean age, 67 years; range, 54-83 y) underwent endovascular treatment of aortic IMH. Thirteen patients were admitted for acute aortic syndrome and two for traumatic aortic injury.

Dramatic improvement in survival after lung transplantation over time: a single center experience.

Lung transplantation (LT) is a recognized procedure for selected patients with end-stage respiratory failure. We performed 123 LT, including 32 single lung, 84 double lung, and 7 heart-lung transplantations in 48 patients with chronic obstructive pulmonary disease (COPD), 13 patients with pulmonary hypertension (PH), 33 with cystic fibrosis (CF), and 29 with interstitial lung disease (ILD) between July 1990 and January 2008. Survival was compared for periods before and after December 2001.

Prevalence, therapeutic management and medium-term prognosis of spontaneous coronary artery dissection: results from a database of 11,605 patients.

Objective: To assess the prevalence, clinical presentation, therapeutic management and medium-term prognosis of spontaneous coronary artery dissection (SCAD).

Methods: Over a 5-year period, and out of a cath-lab database of 11,605 files, 23 cases of SCAD were confirmed by re-analysis of angiograms. Therapeutic management and in-hospital outcome were obtained from medical files and prospective follow-up was performed.

Unusual aortic stent complication after endovascular repair of the descending thoracic aorta in type B dissection in a patient with giant-cell arteritis.

The advent of endovascular prostheses to treat descending thoracic aortic lesions offers an alternative approach in patients who are poor candidates for surgery. We present a case of a type B descending thoracic aortic dissection with rapid aneurysmal evolution in a woman with a giant-cell arteritis, treated by endovascular repair: 26 months after, we observed the anterior dislocation of the distal segment of the stent. The dislocation required a second treatment in order to avoid the aortic wall rupture and to restore the axis of the prosthesis.

Giant aneurysm of the proximal segment of the left anterior descending artery in a patient with Behçet's disease--a combined approach.

Behçet's disease is an autoimmune, multisystem disease presenting with recurrent oral and genital ulceration as well as ocular involvement. Aneurysmal degeneration of coronary arteries remains a rare phenomenon in Behçet's disease. The case of a patient with Behçet's disease who presented with severe stenosis of the left anterior descending artery associated with a giant aneurysm of the proximal segment is described.

Hypoxemia-orthodeoxia related to patent foramen ovale without pulmonary hypertension.

Objective: Patent foramen ovale (PFO) is frequent but rarely associated with platypnea-orthodeoxia syndrome and with no pulmonary hypertension.

Materials And Methods: We performed a retrospective analysis of 12 consecutive patients with hypoxemia and PFO without increased pulmonary arterial pressure. The study was conducted at a single-center university hospital.

[Prospective evaluation of fracture risk in osteoporotic patients after low cement volume vertebroplasty].

Purpose: To prospectively compare the incidence of new fractures (as demonstrated on MR) within the first 3 months after an initial fracture in a population treated with low cement volume vertebroplasty and a population treated conservatively.

Materials And Methods: From 49 patients admitted for osteoporotic vertebral compression fracture, 22 underwent CT guided vertebroplasty with injection of 1-3 ml of PMMA, and 27 were treated conservatively. All patients underwent MR at presentation and at 3 months to detect new compression fractures.